What is a key sign of peritonitis that would necessitate further investigation?

A distended abdomen is a key sign of peritonitis that would necessitate further investigation. This condition indicates the presence of inflammation or irritation of the peritoneum, which can be due to various abdominal pathology, such as infection, perforation of a viscera, or internal bleeding. A distended abdomen may result from the accumulation of fluid, gas, or other contents, which can lead to significant complications if not addressed promptly.

When assessing for peritonitis, certain physical examination findings are crucial. A distended abdomen often accompanies symptoms like tenderness and pain and may suggest an underlying serious condition like bowel obstruction or perforation, further warranting imaging studies or surgical evaluation. The presence of distention can also reflect ascites or a mass effect within the abdominal cavity, both of which require urgent clinical attention to determine the cause and initiate appropriate management.

On the other hand, localized tenderness, bradycardia, and pain response to palpation are also significant but may not singularly indicate the acute nature or severity of peritonitis as clearly as a distended abdomen does. Localized tenderness might suggest localized inflammation, while pain response to palpation can indicate general discomfort but may not capture the extent of abdominal involvement as effectively as distention. Brady